Despite The University of Sydney consistently receiving the highest possible ERA score for its research in the discipline of ophthalmology since the inception of the ERA in 2011, funding for the most important research has become an increasing struggle, according to Peter McCluskey, Professor of Clinical Ophthalmology and Eye Health, and Director of Save Sight Institute at the Faculty of Medicine and Health at the University of Sydney.
The Save Sight Institute operates 11 research groups involved in both clinical and basic eye research, encompassing the common causes of blindness such as age-related macular degeneration, diabetic retinopathy, cataract and corneal disease. Additional research groups target glaucoma, electrophysiology, genetic eye disease, uveitis and ocular cancer.
Outcomes from the Institute’s work have had a global impact. Data from the Fight Retinal Blindness! Register established by Professor Mark Gillies for example, has changed the way ophthalmologists around the world are treating wet AMD.
funding is needed to support research into the big picture of eye care delivery in Australia
“It is very difficult to get funding,” Professor McCluskey told mivision. “Research grants from the National Health and Medical Research Council (NHMRC – Australia’s peak funding body for medical research) are down from 30% to around 7%, which means you’re lucky to get one research grant every ten years. This makes it very difficult to attract young researchers and give them a sustainable career pathway – they run out of money and there is little alternative funding to access.
“The Medical Research Future Fund (MRFF) was supposed to have been put in place to overcome funding issues with the NHMRC, but it seems to have become politicised – it is now difficult to understand how the MRFF process works in practice.”
Professor McCluskey believes eye care professionals need to be more strident when arguing the need for research funding.
“Ophthalmologists have to become better lobbyists of Government so that we can make sure Government and the funding bodies understand the importance of good vision, and:
- how common vision impairment is and what effect that has on allowing people to be productive, healthy members of the community,
- the impact of eye disease on aging,
- the impact of eye disease on our health budget, and
- the global impact on our economy.”
TIME TO LOOK AT THE BIG PICTURE
As well as researching specific eye diseases, Professor McCluskey believes funding is needed to support research into the big picture of eye care delivery in Australia.
In 2019, he led an Australia wide academic and industry collaboration that unsuccessfully submitted a research grant application to the MRFF with the aim of leading a national research program that would ultimately develop a strategy to manage the increasing demands on the health system for eye care.
“This is something we need to look at now, because the problem we face is that with the baby boomer population turning into older adults, and the broader population growing at a faster rate than anticipated (Sydney’s population has already exceeded predictions for 2030), there will be large increases in the need for eye care especially for older Australians. We are going to need more healthcare resources to look after our population,” said Professor McCluskey.
As well as understanding age-related eye disease, he pointed to the consequences of Australia’s increasingly ethnically diverse population.
“We live in an increasingly ethnically diverse, global community, which means we need to be aware of different patterns of disease prevalent in migrants’ home countries. Tuberculosis (TB), for example, is uncommon in Australia, but endemic in countries that many migrants to Australia have come from. Such people don’t have active infection, but they may have been exposed to TB and have latent disease. At some point they can develop ocular inflammation related to their latent tuberculosis. Such tubercular uveitis is one of the commonest infectious causes of uveitis in my uveitis clinic.”
Faced with these significant population changes and increases, Professor McCluskey said, “No single group of eye care providers can independently look after all the eye care needs of our community. We need multi-disciplinary eye care teams led by ophthalmologists, that work collaboratively to look after Australia’s growing needs. It’s quite clear that this is something that needs to happen.”
With the election over, Professor McCluskey hopes to revisit opportunities to form the Australia wide research project.
“We haven’t had an opportunity to talk to Health Minister Greg Hunt, however now that the Government has been re-elected, this is one of the things we will be doing. We would like to meet with him to talk to him about strategies we can develop to manage eye health into the future.”
ABOUT THE ERA REPORT
The State of Australian University Research 2018–19: ERA National Report evaluates the quality of Australian university research, benchmarked against world standards in a comprehensive way.
The report rates university disciplines from one to five, with five being highest. This year, five universities received the highest score for ophthalmology and optometry, being University of Western Australia, University of Sydney, Australian National University, Flinders University of South Australia, and University of Tasmania.
Queensland University of Technology (QUT) and the University of Melbourne received a rating of four, and the University of New South Wales and Macquarie University received a rating of three.
According to Professor Sue Thomas, CEO of the Australian Research Council the report is “a comprehensive assurance mechanism for providing confidence to Government and the Australian public about their investment in Australian university research.”